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Chronic stress–induced ANPEP drives liver cancer progression by increasing glutathione synthesis and inhibiting ferroptosis
Yongkang Wu, Yankun Zhang, Xiaojia Shi, Mengting Wu, Min Sun, Ying Feng, Wenmeng Ma, Xiule Jiang, Dingqi Fei, Mingjian Zhao, Zhuanchang Wu, Chunyang Li, Xiaohong Liang, Lifen Gao, Chunhong Ma, Xuetian Yue
Yongkang Wu, Yankun Zhang, Xiaojia Shi, Mengting Wu, Min Sun, Ying Feng, Wenmeng Ma, Xiule Jiang, Dingqi Fei, Mingjian Zhao, Zhuanchang Wu, Chunyang Li, Xiaohong Liang, Lifen Gao, Chunhong Ma, Xuetian Yue
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Research Article Cell biology Gastroenterology Hepatology

Chronic stress–induced ANPEP drives liver cancer progression by increasing glutathione synthesis and inhibiting ferroptosis

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Abstract

Emerging evidence demonstrates that chronic stress alters immunological, neurochemical, and endocrinological functions, thereby promoting tumor progression. However, the underlying metabolic mechanism of chronic stress in tumor progression is still elusive. Using multiomics analysis, we found that aminopeptidase N (ANPEP) was upregulated in tumors with chronic restraint, associating with the reprogramming of amino acid metabolism. Functional assays revealed that ANPEP promoted liver cancer growth and metastasis. Knockdown of ANPEP blocked chronic stress–induced liver cancer progression. Chronic stress–induced glucocorticoids promoted nuclear receptor subfamily 3 group C member 1 nuclear translocation to activate ANPEP transcription by directly binding to its promoter. Furthermore, ANPEP promotes glutathione synthesis, subsequently inhibiting ROS-induced ferroptosis. Mechanistically, ANPEP interacted with solute carrier family 3 member 2 (SLC3A2) to block membrane associated ring-CH-type finger 8–mediated lysosome-dependent degradation of SLC3A2, promoting intracellular l-cystine transport, thereby increasing glutathione synthesis. The combination of ANPEP silencing and sorafenib treatment showed a synergistic effect in inhibiting liver cancer progression. Finally, clinical data and mouse models demonstrated that chronic stress drove liver tumor progression via ANPEP-regulated SLC3A2. These findings reveal unanticipated communication between chronic stress and metabolic reprogramming during liver cancer progression, providing potential therapeutic implications for liver cancer.

Authors

Yongkang Wu, Yankun Zhang, Xiaojia Shi, Mengting Wu, Min Sun, Ying Feng, Wenmeng Ma, Xiule Jiang, Dingqi Fei, Mingjian Zhao, Zhuanchang Wu, Chunyang Li, Xiaohong Liang, Lifen Gao, Chunhong Ma, Xuetian Yue

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Figure 3

ANPEP mediates chronic stress–induced liver cancer progression.

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ANPEP mediates chronic stress–induced liver cancer progression.
(A) Repr...
(A) Representative immunohistochemical images of tumor tissues and adjacent nontumor tissues stained with anti-ANPEP antibody in patients with HCC. ANPEP-positive staining was quantified using ImageJ (NIH) and statistically analyzed (n = 60 per group). Subgroup analyses based on tumor diameter (<6 cm, n = 34; ≥6 cm, n = 30) and pathological grade (I ≤ grade ≤ II, n = 47; II < grade ≤ III, n = 16). (B–D) Xenograft models established with Huh7-Vector or Huh7-ANPEP cells. Tumor growth curves (n = 10) (B), tumor images and weights (n = 7) (C), and Ki67-positive cells (n = 5) (D) are shown. (E) Lung metastasis models established by tail vein injection of Huh7-Vector or Huh7-ANPEP cells. Representative H&E-stained lung sections and quantification of metastatic area are shown (n = 5). (F–I) Huh7 control shRNA (Huh7-shNC) and Huh7-shANPEP xenograft tumors and lung metastatic nodes in nude mice with or without restraint stress. Tumor growth (n = 9) (F), tumor images and weights (n = 8) (G), Ki67 staining (n = 5) (H), and lung metastases (n = 5) (I) were analyzed. Data are presented as mean ± SD. Statistical significance was determined by 2-way ANOVA with Šidák’s multiple comparisons test (B and F), 1-way ANOVA with Tukey’s multiple comparisons test (G–I), and 2-tailed unpaired Student’s t test (A and C–E). *P < 0.05; **P < 0.01; ***P < 0.001.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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